Children's Home run by Options Autism (5) Limited in Shropshire

Inspection report for children’s home - monitoring visit: SC361167 1 SC361167 Registered provider: Options Autism (5) Limited

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Inspected under the social care common inspection framework

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Information about this children’s home

This service provides care for children with autism spectrum disorder. The children may also have additional medical and/or complex needs.

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Information about this children’s home

This setting is an independent residential special school registered as a children’s home. It is owned and operated by a private company. The service offers specialised education and care for up to eight children at present.

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Information about this children’s home

The provider has recently appointed a new manager who will need to apply to register with Ofsted.

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Information about this children’s home

Due to COVID-19, at the request of the Secretary of State, we suspended all routine inspections of social care providers carried out under the social care common inspection framework (SCCIF) on 17 March 2020. We returned to routine SCCIF inspections on 12 April 2021.

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This monitoring visit

On 26 and 27 October 2021, Ofsted carried out a full inspection at this home. Following this inspection, we raised a compliance notice in respect of issues relating to physical intervention. This monitoring visit is to review the progress managers and staff have made in meeting the steps outlined in the compliance notice. In addition, inspectors reviewed progress made by the provider in addressing shortfalls identified at the full inspection in relation to medication management and staff recruitment practice.

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This monitoring visit

At the time of this inspection, seven children lived at the home. Since the last inspection, no children have moved out but two children who used to live at the home have returned. They experienced a well-planned transition that helped them to settle quickly. Inspection report for children’s home - monitoring visit: SC361167 2 Improvements to the home environment continue and the refurbishment of one house has been completed. Four children who have moved in are enjoying their new surroundings, which are modern, clean and more homely.

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This monitoring visit

Managers and staff fail to pay attention to matters of health and safety. For example, a child gained access to a part of the site still under reconstruction and refurbishment, because a door had been left unlocked. Although the child was unharmed, this was a near miss resulting in a child being exposed to risks from building equipment and exposed wiring. In addition, some food is not stored safely. Staff had failed to notice that a freezer was not working properly and food had started to thaw. These shortfalls cast doubt on the effectiveness of routine health and safety checks undertaken by staff.

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This monitoring visit

Aspects of medication management are poor. Children still do not receive their prescribed medication on time. Managers have not addressed this issue, nor have they sought medical advice about what impact these time delays may have on children’s health and behaviour. Labelling on some medication remains unclear. In addition, on one occasion, a member of staff left their personal medication in a child’s bedroom. A lack of investigation into what happened means steps have not been taken to learn lessons. This lack of due diligence and ineffective oversight of medication management has the potential to compromise children’s health and safety.

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This monitoring visit

Improvements have been made to the recording and review of restraint incidents. The location of the incident is now recorded and all staff involved in a restraint or who have witnessed it have a debrief to talk about what happened. In addition, arrangements for checking on children’s welfare following an incident have been developed. For example, each child now has communication tools that staff can support them to use to reflect on what happened. Where it is assessed that a child does not have the capacity to do this, someone who was not involved in the incident checks on the child’s welfare, records their observations and knows to report any concerns. Managers review restraint incidents consistently, although they sometimes do this before staff have had a debrief. This means they may not have access to all relevant information to inform their review of what happened. In addition, although staff now have a debrief, this is undertaken as a group and not individually. This

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This monitoring visit

does not give staff the opportunity to easily raise any concerns they may have about how the incident was managed.

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This monitoring visit

Most records reviewed showed that safer recruitment practice is improving. However, one staff member’s record does not show that suitable references have been sought and verified. A requirement raised at the full inspection about this shortfall will be repeated.

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This monitoring visit

Managers notify Ofsted about serious incidents that occur at the home. This keeps the regulator informed about significant events. When concerns are raised about staff practice or conduct these are responded to promptly and investigated. Inspection report for children’s home - monitoring visit: SC361167 3 Investigations are thorough and reports set out recommendations to prevent reoccurrence. However, senior managers do not act on these recommendations quickly, which leads to drift and delay in bringing about improvements to the quality of care children receive.

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This monitoring visit

Adherence to regulations 9, 13 and 33 was not reviewed in full at this monitoring visit because the provider still had a month in which to meet the requirements set. These remain and will be reviewed at the next inspection. A new requirement in relation to regulation 12 is raised. Regulation 32 is repeated and a compliance notice is issued in relation to regulation 23.

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Inspection date Inspection type Inspection judgement

26/10/2021 Full Requires improvement to be good 04/08/2021 Full Inadequate 22/10/2019 Full Good 27/06/2018 Full Good Inspection report for children’s home - monitoring visit: SC361167 4

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Statutory Requirements

This section sets out the actions that the registered person(s) must take to meet the Care Standards Act 2000, Children’s Homes (England) Regulations 2015 and the ‘Guide to the children’s homes regulations, including the quality standards’. The registered person(s) must comply within the given timescales.

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Requirement Due date

The enjoyment and achievement standard is that children take part in and benefit from a variety of activities that meet their needs and develop and reflect their creative, cultural, intellectual, physical and social interests and skills.

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Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to ensure—

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Requirement Due date

make a positive contribution to the home and the wider community; and

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Requirement Due date

that each child has access to a range of activities that enable the child to pursue the child’s interests and hobbies. (Regulation 9 (1) (2)(a)(iii)(b))

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Requirement Due date

In particular, ensure that all children are supported to access the community, and that plans are progressed and implemented without delay. 12 January 2022

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Requirement Due date

The protection of children standard is that children are protected from harm and enabled to keep themselves safe.

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Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to ensure—

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Requirement Due date

that the premises used for the purposes of the home are located so that children are effectively safeguarded. (Regulation 12 (1) (2)(c)) 30 January 2022

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Requirement Due date

The leadership and management standard is that the registered person enables, inspires and leads a culture in relation to the children’s home that—

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Requirement Due date

helps children aspire to fulfil their potential; and

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Requirement Due date

promotes their welfare. 12 January 2022 Inspection report for children’s home - monitoring visit: SC361167 5 In particular, the standard in paragraph (1) requires the registered person to—

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Requirement Due date

lead and manage the home in a way that is consistent with the approach and ethos, and delivers the outcomes, set out in the home’s statement of purpose;

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Requirement Due date

use monitoring and review systems to make continuous improvements in the quality of care provided in the home. (Regulation 13 (1)(a)(b) (2)(a)(h))

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Requirement Due date

In particular, continue to embed new monitoring and audit systems and use these to their full effect to promote children’s progress and experiences.

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Requirement Due date

*The registered person must make arrangements for the handling, recording, safekeeping, safe administration and disposal of medicines received into the children’s home.

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Requirement Due date

In particular the registered person must ensure that—

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Requirement Due date

medicines kept in the home are stored in a secure place so as to prevent any child from having unsupervised access to them;

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Requirement Due date

medicine which is prescribed for a child is administered as prescribed to the child for whom it is prescribed and to no other child. (Regulation 23 (1) (2)(a)(b))

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Requirement Due date

In particular, ensure that all medication brought into the home is stored securely and administered safely and in a timely way. 30 January 2022

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Requirement Due date

The registered person must recruit staff using recruitment procedures that are designed to ensure children’s safety.

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Requirement Due date

employ an individual to work at the children’s home; or

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Requirement Due date

if an individual is employed by a person other than the registered person to work at the home in a position in which the individual may have regular contact with children, allow that individual to work at the home,

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Requirement Due date

if the individual satisfies the requirements in paragraph (3). 30 January 2022 Inspection report for children’s home - monitoring visit: SC361167 6 The requirements are that—

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Requirement Due date

full and satisfactory information is available in relation to the individual in respect of each matters in Schedule 2. (Regulation 32 (1) (2)(a)(b) (3)(d))

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Requirement Due date

The registered person must ensure that all employees—

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Requirement Due date

receive practice-related supervision by a person with appropriate experience; and

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Requirement Due date

have their performance and fitness to perform their roles appraised at least once every year. (Regulation 33 (4)(b)(c))

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Requirement Due date

This specifically relates to the registered person ensuring that staff receive regular supervision and an annual appraisal. 12 January 2022

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Requirement Due date

*These requirements are subject to a compliance notice.

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Recommendation

 The registered person should ensure that all incidents of restraint are subject to systems of regular scrutiny to ensure that their use is fair. In particular, consider the benefits of individually debriefing staff involved in or witness to a restraint incident and ensure that managers take account of all relevant information when reviewing restraint incidents. (‘Guide to the children’s homes regulations, including the quality standards,’ page 46, paragraph 9.36)

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Information about this inspection

The purpose of this visit was to monitor the action taken and the progress made by the children’s home since its last Ofsted inspection.

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Information about this inspection

This inspection was carried out under the Care Standards Act 2000. Inspection report for children’s home - monitoring visit: SC361167 7

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Children’s home details

Registered provider: Options Autism (5) Limited

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Children’s home details

Registered provider address: Atria, Spa Road, Bolton BL1 4AG

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Inspectors

James Tallis, Social Care Inspector Jackie Line, Social Care Inspector Inspection report for children’s home - monitoring visit: SC361167 8 to achieve excellence in the care of children and young people, and in education and skills for learners of all ages. It regulates and inspects childcare and children’s social care, and inspects the Children and Family Court Advisory and Support Service (Cafcass), schools, colleges, initial teacher training, further education and skills, adult and community learning, and education and training in prisons and other secure establishments. It assesses council children’s services, and inspects services for children looked after, safeguarding and child protection.

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Inspectors

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Inspectors

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Inspectors

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